Link to article: American Gastroenterological Association Institute Guideline on the Management of Crohn’s Disease After Surgical Resection (Full Text)
C Geoffrey et. Gastroenterol DOI: http://dx.doi.org/10.1053/j.gastro.2016.10.038
Top Posts 2016
The following posts are the ones that I think are most useful from 2016.
Gastroenterology:
- Is Intestinal Function in Children with Autism Different? | gutsandgrowth
- How Likely is Reflux in Infants with “Reflux-like … – gutsandgrowth
- Is a Gluten-Free Diet a Heathy Diet for Those without Celiac Disease
- Ultra-Short Celiac Disease | gutsandgrowth
- Adrenal Insufficiency due to Fluticasone in … – gutsandgrowth
- Adverse Events Following Pediatric Endoscopy … – gutsandgrowth
- Don’t Skip this Article -Rome IV Summary | gutsandgrowth
- Rome IV -Pediatric Changes | gutsandgrowth
Liver:
- Bad News Bili | gutsandgrowth
- Changing Approach to Neonatal Acute Liver Failure | gutsandgrowth
- Biliatresone- Early Preview of Basic Science Lecture
- Intellectual Disability in Pediatric Liver Transplantation | gutsandgrowth
General:
- Why Some Kids Are Short
- Topamax and Amitriptyline Did Not Work for Pediatric Migraines
- What to Make of a Low Alkaline Phosphatase | gutsandgrowth
- CDC Guideline for Prescribing Opioids for Chronic Pain | gutsandgrowth
- ERAS -Enhanced Recovery After Surgery | gutsandgrowth
- Patient assistance for lab testing
- John Oliver and Understanding Scientific Studies
- Expert Review: GMOs are Safe
- NY Times: “Never Diet Again” | gutsandgrowth
Doctoring:
IBD:
- Landmark Study: Ustekinumab
- Lower Fiber Intake May Increase Risk of Crohn’s Flare | gutsandgrowth
- How helpful are serologies in pediatric inflammatory … – gutsandgrowth
- 4 Points for C diff in Inflammatory Bowel Disease | gutsandgrowth
- What to Make of Post-op Treatment for Crohn’s Disease | gutsandgrowth
- CCFA Conference Notes 2016 (part 2) -Pediatric … – gutsandgrowth
Nutrition:
- Detrimental Effect of Early Parenteral Nutrition in … – gutsandgrowth
- Latest Obesity Data Discouraging | gutsandgrowth
- Changing Practice Patterns with Pediatric Pancreatitis | gutsandgrowth
- Parent Perspective, Pediatric Nutritionist and Traci Nagy | gutsandgrowth
- The “EAT” Study | gutsandgrowth
Bad Combination? Lansoprazole and Ceftriaxone
From Gastroenterology & Endoscopy News Nov 2016: Giving PPIs and Antibiotics Together May Disrupt Heart Rhythm
An excerpt:
Taking two common drugs—an over-the-counter proton pump inhibitor (PPI) and an antibiotic—together was associated with an increased risk for life-threatening arrhythmia (J Am Coll Cardiol 2016 Oct 10. [Epub ahead of print]).
New York researchers scanned data from two independent databases to investigate possible QT interval–prolonging drug–drug interactions: 1.8 million adverse event reports from the FDA’s Adverse Event Reporting System and 1.6 million ECGs from 382,221 patients treated at NewYork-Presbyterian Hospital/Columbia University Medical Center, in New York City, between 1996 and 2014…
In the study, patients taking ceftriaxone, a cephalosporin antibiotic, and the PPI lansoprazole were 40% more likely to have a QT interval above 500 milliseconds, the current FDA-stated threshold of clinical concern. Among men taking the two drugs, QT intervals were 12 milliseconds longer than men who took either drug alone…
The interaction identified in the data analysis was specific to lansoprazole and ceftriaxone, but not other cephalosporins.
My take: The magnitude of this risk is very low for a single individual but is important when one considers how many patients could be taking this combination of medications.
Tweet Week -Dark Humor
Tweet Week -Flu Shot
Image
Tweet Week -Geographic Mortality Maps
Tweet Week -Block Grants Results in Medicaid Cuts
Tweets only this week.
Tweet Week -Health Coverage & Pre-existing Conditions + IBD Tweets
Also -some tweets from IBD meeting:
Tweet Week -Preexisting Conditions Before (? and After) Affordable Care Act
Characterizing Severe Liver Disease with Cystic Fibrosis
A recent retrospective study (JR Stonebraker et al. Clin Gastroenterol Hepatol 2016; 14: 1207-15) examined data from 561 patients (76 international centers) with cystic fibrosis (CF), liver disease and portal hypertension. The study period spanned 1999-2013. Key findings:
- Male patients were diagnosed earlier: 10 vs 11 year, p =.01. 63% of patients were males.
- Splenomegaly was noted in 99% and varices in 71%
- Levels of liver enzymes were near normal in most patients. 63% had transaminases that were less than 2 x ULN.
- 91 (16%) received liver transplants at a median age of 13.9 years. Hallmarks of those receiving liver transplants included lower platelet counts (78 vs 113, P<.0001), higher INR (1.4 vs 1.2, P<.0001), and lower albumin (3.3 vs 3.7, P =.0002).
- 99% of patients in this cohort were pancreatic insufficient
My take: In patients with CF, those with severe liver disease often present by age ~10 years. Features of portal hypertension, like splenomegaly and low platelet counts, appear to be more important than liver enzymes.
Related blog posts:
gutsandgrowth 